Your Name
*
Email Address
*
Phone
*
City (Important to know local grocery stores)
State
How would you describe your normal daily activities?
Sedentary: Spend most of the day sitting (e.g. bank taller, desk job)
Lightly Activity: Spend a good part of the day on your feet (e.g. teacher, salesman)
Active: Spend a good part of the day doing some physical activity (e.g. waitress, mailman)
Very Active: Spend most of the day doing heavy physical activity (e.g. bike messanger, carpenter)
Height
Age
I want to:
Mostly want to lose fat
Move better, lose some fat, and gain some strength.
Put on some size
Mostly want to build muscle; I’m not concerned with fat loss.
Current Weight:
Goal Weight:
How many days per week do you exercise?
How many minutes per day do you exercise (cardio & weight lifting combined)?
What is your biggest nutritional challenge?
What is your biggest nutritional challenge?
Cravings
I don't know how to cook
Don’t know what I should eat
Eating out frequently
Eating quickly
Emotional eating/stress eating
Family/peer pressure
Lack of a supportive environment
Large portions
Lack of planning
Snacking when not hungry
Sweet tooth
Time to prepare meals
Wine / alcohol
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If you had to pick just one nutritional struggle from the list above, which challenge would you consider to be your most difficult to overcome and why?
On an average day, how many glasses of water do you drink?
0-2
3-5
6-8
8+
On a scale of 1-10, how knowledgeable are you about making smart food choices?
Which best describes you?
I want basic, inexpensive, routine meals to make to reach my goals (Most affordable due to a simple grocery list)
I need a wide variety of weekly meals to stick to my meal plan. (More costly due to a larger grocery list.)
I'm not picky, I want the best meal plan that'll help me accomplish my body goals.
Number of Meals Per Day:
2
3
Number of Snacks Per Day:
1
2
How Many Different Lunches do you want Mon-Sun? (The fewer the meals, the easier it is to remain consistent and meal prep.)
1
2
3
How many Different Dinner meals do you want Mon-Sun ? (The fewer the meals, the easier it is to remain consistent and meal prep.)
1
2
3
ARE THERE ANY (VEGAN) FOODS THAT YOU REFUSE TO EAT?
ARE THERE ANY VEGAN FOODS THAT YOU REALLY WANT TO EAT?
What do you do for a living?
Do you work days, afternoon or nights?
Days (ex. 9am-5pm, etc.)
Afternoons (12pm-9pm, etc.)
Nights (11pm-7am, etc.)
I have a rotating schedule and do shift work
What's your activity level at work?
Inactive; I'm mostly sitting
Moderate; I'm on my feet for a part of every day
Active; I'm moving all day
Very active; I do physical labor
What is your typical stress level at work?
Low stress; my work is pretty relaxed
Moderate stress; it's sometimes relaxed and sometimes crazy
High stress; I'm always under pressure
Is there anything else we should know that would be useful for tailoring your plan?
LET'S GET STARTED